The Journal of the American Board of Family Practice, Vol 15, Issue 6 463-472, Copyright © 2002 by American Board of Family Practice

ARTICLES

Characteristics of visits to licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians

D. C. Cherkin, R. A. Deyo, K. J. Sherman, L. G. Hart, J. H. Street, A. Hrbek, R. B. Davis, E. Cramer, B. Milliman, J. Booker, R. Mootz, J. Barassi, J. R. Kahn, T. J. Kaptchuk and D. M. Eisenberg
Center for Health Studies, Group Health Cooperative, Seattle 98101, USA.

BACKGROUND: Despite growing popularity of complementary and alternative medical (CAM) therapies, little is known about the patients seen by CAM practitioners. Our objective was to describe the patients and problems seen by CAM practitioners. METHODS: We collected data on 20 consecutive visits to randomly sampled licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians practicing in Arizona, Connecticut, Massachusetts, and Washington. Data were collected on patient demographics, smoking status, referral source, reasons for visit, concurrent medical care, payment source, and visit duration. Comparative data for conventional physicians were drawn from the National Ambulatory Medical Care Survey. RESULTS: In each profession, at least 99 practitioners collected data on more than 1,800 visits. More than 80% of visits to CAM providers were by young and middle-aged adults, and roughly two thirds were by women. Children comprised 10% of visits to naturopathic physicians but only 1% to 4% of all visits to other CAM providers. At least two thirds of visits resulted from self-referrals, and only 4% to 12% of visits were from conventional physician referrals. Chiropractors and massage therapists primarily saw musculoskeletal problems, while acupuncturists and naturopathic physicians saw a broader range of conditions. Visits to acupuncturists and massage therapists lasted about 60 minutes compared with 40 minutes for naturopathic physicians and less than 20 minutes for chiropractors. Most visits to chiropractors and naturopathic physicians, but less than one third of visits to acupuncturists and massage therapists, were covered by insurance. CONCLUSIONS: This information will help inform discussions of the roles CAM practitioners will play in the health care system of the future.

This article has been cited by other articles:

				B. Brinkhaus, C. M. Witt, S. Jena, K. Linde, A. Streng, S. Wagenpfeil, D. Irnich, H.-U. Walther, D. Melchart, and S. N. Willich Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med, February 27, 2006; 166(4): 450 - 457. [Abstract] [Full Text] [PDF]

				M. S Goldstein, E. R. Brown, R. Ballard-Barbash, H. Morgenstern, R. Bastani, J. Lee, N. Gatto, and A. Ambs The Use of Complementary and Alternative Medicine Among California Adults With and Without Cancer Evid. Based Complement. Altern. Med., December 1, 2005; 2(4): 557 - 565. [Abstract] [Full Text] [PDF]

				E. Manheimer, A. White, B. Berman, K. Forys, and E. Ernst Meta-Analysis: Acupuncture for Low Back Pain Ann Intern Med, April 19, 2005; 142(8): 651 - 663. [Abstract] [Full Text] [PDF]

				A. Bellas, W. E. Lafferty, B. Lind, and P. T. Tyree Frequency, Predictors, and Expenditures for Pediatric Insurance Claims for Complementary and Alternative Medical Professionals in Washington State Arch Pediatr Adolesc Med, April 1, 2005; 159(4): 367 - 372. [Abstract] [Full Text] [PDF]

				K. J. Sherman, D. C. Cherkin, D. M. Eisenberg, J. Erro, A. Hrbek, and R. A. Deyo The Practice of Acupuncture: Who Are the Providers and What Do They Do? Ann. Fam. Med, March 1, 2005; 3(2): 151 - 158. [Abstract] [Full Text] [PDF]

				K. Wilson, J. W. Busse, A. Gilchrist, S. Vohra, H. Boon, and E. Mills Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada Pediatrics, March 1, 2005; 115(3): e338 - e343. [Abstract] [Full Text] [PDF]

				B. R. Cassileth and G. Deng Complementary and Alternative Therapies for Cancer Oncologist, February 1, 2004; 9(1): 80 - 89. [Abstract] [Full Text] [PDF]

				D. C. Cherkin, K. J. Sherman, R. A. Deyo, and P. G. Shekelle A Review of the Evidence for the Effectiveness, Safety, and Cost of Acupuncture, Massage Therapy, and Spinal Manipulation for Back Pain Ann Intern Med, June 3, 2003; 138(11): 898 - 906. [Abstract] [Full Text] [PDF]